Active Life Medical & Wellness
Organization Active NPI Family Medicine Physician · Bakersfield, CA
NPI 1144855461 · NPPES record last updated Mar 6, 2020
Key facts
- NPI
- 1144855461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ACTIVE LIFE MEDICAL & WELLNESS
- Practice address
- 3015 Calloway Dr Ste D6
Bakersfield, CA 93312-2657 - Phone
- (661) 834-1544
- Fax
- (661) 837-2233
- NPI assigned
- Mar 6, 2020
- Organization subpart
- No
Authorized official
- Name
- Jason Sabol, DC
- Title
- Provider
- Phone
- (661) 834-1544
Practitioners 5
-
Ronald Joseph Ostrom, D.O.
-
Mukesh Patel, P.A.
-
Eric J Walker, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240521002778 | CA | Part B Supplier - Clinic/Group Practice | 7810339934 |
Receives reassigned benefits from 3 practitioners Practice locations: Bakersfield, CA |
National Provider Directory
Locations
3015 Calloway Dr
#D6
Bakersfield, CA 93312
3015 Calloway Dr
Ste D6
Bakersfield, CA 93312
Phone (661) 368-6822
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
3015 Calloway Dr Ste D6
Bakersfield, CA 93312-2657
Mailing address
3015 Calloway Dr Ste D6
Bakersfield, CA 93312-2657
Phone (661) 834-1544
Other providers in Bakersfield, CA
- Ysidora Acosta
- Action Family Counseling - Bakersfield Inc
- Action Family Counseling Bakersfield RTC
- Neil Actis
- Active Care Supply LLC
- Natasha Acupan
- Renee Grace Acupan
- Shiela P Acusar
- Efleida Adalia
- Kathi Adam
All providers in Bakersfield, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.